Asperger’s vs. Autism: What’s the Difference?

If you have a child on the autism spectrum, understanding their diagnosis is essential. The more you know, the better you can help your child get the care and support they need.

But understanding an autism disorder diagnosis isn’t always easy. A lot has changed in a short period of time. And some of the terminology you’re used to hearing may no longer be accurate. For example, Asperger’s syndrome and autism both affect brain development.

“The lines between Asperger’s and autism were often gray,” says developmental-behavioral pediatrician Carrie Cuffman, MD. “We now consider them one condition — autism spectrum disorder (ASD).”

So, ASD is the condition people get diagnosed with today, but there are plenty of people who still use the terms “autism,” “Asperger’s” and “autism spectrum” interchangeably. Dr. Cuffman clarifies the differences between Asperger’s and autism — and explains the switch to ASD.

Autism, Asperger’s and autism spectrum disorder

In order to understand the difference between Asperger’s and autism, we need to do a little history lesson. Autism first became a diagnosable disorder in 1911. Paul Eugen Bleuler, the Swiss psychiatrist credited with discovering the condition, incorrectly believed that autism was a form of childhood schizophrenia. Autism grew as a common diagnosis between the 1960s and 1980s as providers became more aware of the condition.

Asperger’s syndrome came later. The name is a reference to an Austrian pediatrician named Hans Asperger. In 1944, he observed a group of children who didn’t quite fit the autism diagnosis of the time but did display evidence of a similar neurodevelopmental impairment. His findings, though significant, didn’t get much attention until the 1980s, when a British psychiatrist named Lorna Wing coined the term “Asperger’s syndrome.” It became an official diagnosis in 1994.

Having both Asperger’s and autism as possible diagnoses got really confusing really fast. And they weren’t even the only diagnoses! Some kids were diagnosed with pervasive developmental disorder or childhood disintegrative disorder instead. Those conditions also ended up being subsumed by ASD.

All four of these conditions shared at least a few symptoms, which made it difficult to decide what diagnosis was best. The brain is a complicated thing — and no two people had the exact same symptoms or care needs. Many individuals didn’t fit any diagnosis. In some cases, the result was no diagnosis at all — which also meant not receiving any of the early interventions that can be so helpful.

In 2013, the American Psychiatric Association released the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In the DSM-5, experts combined both autism and Asperger’s under the broad umbrella of ASD (autism spectrum disorder). That means that — in countries that use the DSM-5 — it’s no longer possible to be diagnosed with Asperger’s or autism.

“This new classification reflects a better understanding of Asperger’s and autism and how they overlap,” says Dr. Cuffman. “Grouping them as a spectrum makes a lot of sense.”

Think of the autism spectrum as a range of symptoms and abilities. When it was a stand-alone condition, providers considered Asperger’s to be a milder form of autism.

When diagnosing autism spectrum disorder today, providers look for patterns of symptoms. They also consider when symptoms first appeared and how they impact your child’s daily life. The main signs of ASD include:

• Problems with communication and social interaction.
• Repetitive behaviors, interests or activities.

Those categories are broad enough that a lot of different symptoms can fit. Ideally, that means fewer kids falling through the cracks, earlier intervention and greater support for caregivers and families.

What is Asperger’s?

Although Asperger’s is no longer a distinct diagnosis, it accurately describes some people with ASD.

“‘Asperger’s’ is a term still widely used by the public and media,” notes Dr. Cuffman. “People who were diagnosed before it became ASD may consider Asperger’s part of their identity.” If you’ve ever heard somebody describe themselves as an “aspie,” that’s why.

The main feature of Asperger’s (mild ASD) was difficulty with social interactions and fitting in with peers. However, compared to children with autism, children with Asperger’s typically had:

• Appropriate language skills for their age.
• Average or above average intelligence, especially in math and science.
• Fewer repetitive movements.

Dr. Cuffman adds that children with Asperger’s-style symptoms often talk a lot but have specific language differences and interests. Signs of the condition included:

• Difficulty holding a conversation.
• Repetition of words or sounds others make (echolalia).
• Repetitious speech patterns.
• Scripted lines of speech they take from other places.
• Strong interest in topics that may seem usual (like Disney princesses or dinosaurs) or unusual (like flashlights or fans).

What is autism?

Autism typically involved a wider range of symptoms than Asperger’s and a greater level of impairment. In addition to difficulties interacting with others, children diagnosed with autism often displayed:

• Delayed language skills.
• Highly focused interests in specific topics.
• Lack of flexibility in daily routines.
• Repetitive behaviors.

An autism diagnosis would usually occur at a younger age than Asperger’s because the symptoms were more noticeable. Providers could (and still can) diagnose children with autism-style symptoms as early as 18 months. Meanwhile, the typical age for an Asperger’s diagnosis was 3 to 5 years, mainly because the signs were less noticeable. To this day, some people with Asperger’s-style symptoms may not receive a diagnosis until later in childhood, adolescence or adulthood.

Diagnosing ASD

ASD is a common condition. To diagnose it, healthcare providers thoroughly evaluate a child’s abilities.

“It’s important to look at the whole picture,” says Dr. Cuffman. “The evaluation often sheds light on the surprising ways children with ASD develop and learn new skills.”

Your child’s provider may perform specific tests, observe your child’s behavior and ask you questions. Overall, they check for a range of symptoms across several areas, including:

• Social interactions.
• Relationships.
• Behavior.
• Speech.
• Routines.
• Interests.
• Sensory perception.

Treating autism spectrum disorder

ASD has no cure, but early detection and treatment can improve your child’s symptoms and outlook. “The most important aspect of care is capitalizing on your child’s strengths and supporting their differences,” says Dr. Cuffman.

Within ASD, providers categorize a child’s condition by the level of support they need, ranging from one to three:

• Level one: Low level of support.
• Level two: Substantial support.
• Level three: Very substantial support.

Most (but not all) children with Asperger’s-like symptoms need level-one support. Children with autism-style symptoms often need higher-level care. But it’s not a direct comparison, says Dr. Cuffman. For example, a child may have typical language and intelligence but need more support for their behaviors.

The switch from Asperger’s and autism to ASD comes with the recognition that every child is different. And that their needs will grow and change just like the rest of them.

Finding out your child has ASD can trigger a range of emotions and questions. Turn to your healthcare team for accurate information and guidance. They will help your child get the care they need and teach you treatment and behavior-modification strategies to use at home.